11C-PIB-PET/CT与神经心理量表在轻度认知功能障碍和阿尔茨海默病中的相关性研究

Study on the relationship between11C-PIB-PET/CT and neuropsychological scales in mild cognitive impairment and Alzheimer's disease

摘要:

目的： 探索¹¹C-匹兹堡化合物B正电子发射断层扫描成像（[N-methyl-¹¹C]-2-（4-methylaminophenyl）-6-hydroxybenzothiazole，positron emission tomography，¹¹C-PIB-PET/CT）与神经心理量表在轻度认知功能障碍（mild cognitive impairment，MCI）和阿尔茨海默病（Alzheimer's disease，AD）的关系。 方法： 选取吉林大学中日联谊医院神经内科2018年1月至2020年12月符合纳入标准的阿尔茨海默病及轻度认知功能障碍门诊及住院患者27例，收集患者一般资料、神经心理测试量表评分和¹¹C-PIB-PET/CT成像，使用pMOD软件对患者¹¹C-PIB-PET/CT成像进行处理，得到患者各脑区¹¹C-PIB的标准摄取值比（standardized uptake value ratio，SUVR），组间对比得到显著差异的脑区，对所有患者具有显著差异的脑区SUVR与神经心理测试量表进行统计学分析。 结果： ①AD组SUVR均值高于MCI组SUVR均值，组间差异具有统计学意义（P<0.01）。②2组患者SUVR值具有统计学差异（P<0.01）的脑区为：左侧额下回（P=0.009）、左侧额上回（P=0.008）、左侧海马旁回及周围回（P=0.005）、右侧海马旁回及周围回（P=0.002）、左侧梭形回（P=0.002）、右侧梭形回（P=0.003）、左侧中央后回（P=0.003）、右侧楔叶（P=0.008）、左侧壳核（P=0.007）、右侧壳核（P=0.003）、右侧苍白球（P=0.006）、右侧扣带回前部（P=0.004）。③进一步将所有患者差异显著的脑区SUVR值与简易智能测试量表评分（mini-mental state examination，MMSE）及蒙特利尔认知评估（Montreal cognitive assessment，MoCA）行Pearson相关性分析。其中，左侧额上回（r=-0.454，P=0.029）、左侧海马旁回及周围回（r=-0.439，P=0.036）、左侧梭形回（r=-0.421，P=0.045）、左侧中央后回（r=-0.482，P=0.020）SUVR值与MMSE评分呈负相关（P<0.05）。左侧额上回（r=-0.430，P=0.040）、左侧海马旁回及周围回（r=-0.418，P=0.047）、左侧梭形回（r=-0.454，P=0.030）、左侧中央后回（r=-0.477，P=0.021）、左侧壳核（r=-0.422，P=0.045）、右侧壳核（r=-0.419，P=0.047）SUVR值与MoCA评分呈负相关（P<0.05）。 结论： ①AD组患者脑内¹¹C-PIB的SUVR值显著高于MCI组患者。②AD组与MCI组患者多个脑区SUVR值具有显著差异。③额上回（左）、海马旁回及周围回（左）、梭形回（左）、中央后回（左）、壳核（左、右）部位Aβ蛋白沉积水平与认知功能损害相关。研究结果可为AD的早期识别诊断提供一定的影像学证据。

Abstract:

Objective: To explore the relationship between [N-methyl-¹¹C] -2- (4-methylaminophenyl) -6-hydroxybenzothiazole, positron emission tomography (¹¹C-PIB-PET/CT) and neuropsychological scales in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Methods: Twenty-seven outpatients and inpatients with AD and MCI who met the inclusion criteria were selected from the Department of Neurology, China-Japan Union Hospital of Jilin University from January 2018 to December 2020, and general information, neuropsychological test scale scale scores and ¹¹C-PIB-PET/CT imaging of them were collected. The standardized uptake value ratio (SUVR) of ¹¹C-PIB in each brain region of the patients was obtained by processing the patient's ¹¹C-PIB-PET/CT imaging using pMOD software. The brain areas with significant differences were compared between the two groups, and the SUVR and neuropsychological test scale of all patients with statistical differences were statistically analyzed. Results: ①The mean value of SUVR in the AD group was higher than the mean value of SUVR in the MCI group, and the differences between groups were statistically significant (P<0.01). ②There were significant differences in the SUVR values of the brain regions of the two groups of paatients (P<0.01): the left inferior frontal gyrus (P=0.009), left superior frontal gyrus (P=0.008), left parahippocampal gyrus and perirhinal gyrus (P=0.005), right parahippocampal gyrus and perirhinal gyrus (P=0.002), left syrinx (P=0.002), right syrinx (P=0.003), left postcentral gyrus (P=0.003), right cuneus (P=0.008), left cisternal nucleus (P=0.007), right cisternal nucleus (P=0.003), right pallidum (P=0.006) and right anterior cingulate gyrus (P=0.004). ③Further Pearson correlation analysis was performed between the significantly different SUVR values of brain regions and the scores of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) scales in all patients. Among them, the SUVR values of the left superior frontal gyrus (r=-0.454, P=0.029), left parahippocampal gyrus and peripheral gyrus (r=-0.439, P=0.036), left syrinx (r=-0.421, P=0.045), and left postcentral gyrus (r=-0.482, P=0.020) were negatively correlated with MMSE scores (P<0.05). The left superior frontal gyrus (r=-0.430, P=0.040), left parahippocampal gyrus and peripheral gyrus (r=-0.418, P=0.047), left cingulate gyrus (r=-0.454, P=0.030), left postcentral gyrus (r=-0.477, P=0.021), left cisternal nucleus (r=-0.422, P=0.045) and right cisternal nucleus (r=-0.419, P=0.047) SUVR values were negatively correlated with MoCA scores (P<0.05). Conclusion: ①SUVR values of ¹¹CPIB in the brain of patients in the AD group were significantly higher than those of patients in the MCI group. ②SUVR values in several brain regions were significantly different between patients in the AD and MCI groups. ③The levels of Aβ protein deposition in the superior frontal gyrus (left), parahippocampal gyrus and perirhinal gyrus (left), sphenoid gyrus (left), postcentral gyrus (left), and nucleus accumbens (left and right) are associated with MCI. These results can provide some imaging evidence for the early identification and diagnosis of AD.